A medical imaging and therapy device is provided that may include any of a number of features. One feature of the device is that it can image a target tissue volume and apply ultrasound energy to the target tissue volume. In some embodiments, the medical imaging and therapy device is configured controllably apply ultrasound energy into the prostate by maintaining a cavitational bubble cloud generated by an ultrasound therapy system within an image of the prostate generated by an imaging system. The medical imaging and therapy device can be used in therapeutic applications such as Histotripsy, Lithotripsy, and HIFU, for example. Methods associated with use of the medical imaging and therapy device are also covered.